Of the state’s two-year $63 billion all-funds budget, 42 percent goes to health and human services spending, with much coming from the federal government for programs such as welfare. Even from the $35 billion portion of the budget supported by state taxes, nearly a third goes to health and human services programs, second only to education spending.

Lourey said he will advocate spending what the state needs to protect the health of the poor, disabled and elderly who rely on state programs, but must accept whatever funding levels his leaders hand him.

“We are having trouble meeting the needs,” Lourey said. “They have no place else to turn.”

First on the health-care table will be discussion about how to implement “health-care exchanges,” part of a new federal law known as Obamacare. The exchanges, which must be operating in October, will provide a mostly Web-based place for Americans to buy health insurance.

While some Republicans do not think the state should be involved in what they see as a government takeover of health care, others disagree. Sen. Bill Ingebrigtsen, R-Alexandria, said it is important for the state to deal with the issue.

“I think the state should have the control,” Ingebrigtsen said. “We should have more of a say in our health care.”

Federal funds will pay for some of the early operating costs, and already have paid much of the start-up expense, but the state will need to contribute. Lourey said he expects some of the changes needed to comply with the federal law will pass early in the Minnesota legislative session, which begins Jan. 8, but anything that costs much money will be wrapped into budget negotiations that could end in mid-May.

Long-term care

Rural legislators, in particular, will seek more long-term care funding for organizations such as nursing homes.

Long-term care has been “woefully neglected,” Sen.-elect Kent Eken, DFL-Twin Valley, said. “We need to start preparing. We have not been adequately preparing for the current generation, let alone baby boomers.”

Eken is among the Democrats willing to raise taxes if needed. For him, long-term care is worth it. “You can’t do these things for free.”

While recognizing that some programs may be cut, Eken said that long-term care should be spared.

“It is not an issue that has generated the focus and attention I think it deserves,” said Eken, who is moving to the Senate from the House. “I am going to try to change that.”

Mental health, sex offenders

December’s Newtown, Conn., school shooting likely will produce debate on the issue, and Ingebrigtsen said much of the focus should be on better mental health care.

“It should be treated like diabetes,” said Ingebrigtsen, a former sheriff who said he often dealt with violent mentally ill people. “Mental illness has to be dealt with every day.”

Law enforcement officials will be interested in that debate, as well as how to deal with sex offenders who have completed their criminal sentences.

“The federal courts are watching us closely,” Lourey said, after lawsuits advanced claiming Minnesota has no right to keep sex offenders locked up after they have served their time.

Under current law, state courts commit most serious sex offenders to locked state hospitals for treatment after their prison sentences. Patients and other groups say the “treatment” is nothing more than an extended prison sentence since nearly all of the offenders remain locked up indefinitely and never complete treatment.

Lourey does not have a specific plan ready, but said a “less restrictive” option is needed to satisfy the courts. Still, he said, lawmakers need to approve something that keeps the public safe.

“It is either concrete and barbed wire or on the street,” Lourey said of the current situation.

There are many “low functioning” offenders in the system, Lourey said. “I have a new flash for you: We are not going to treat them. There is not a treatment that is going to help them. But we don’t need this level of service (in locked hospitals) to protect public safety.”

Lourey said Minnesota has two choices when dealing with sex offenders: Fix the situation or let the federal courts act.

The latter, he said, would be “a total disaster and a total budget buster.” Federal judges also might not have public safety in mind, he added.

Don Davis has been the Forum Communications Minnesota Capitol Bureau chief since 2001, covering state government and politics for two dozen newspapers in the state. Don also blogs at Capital Chatter on Areavoices.